Nonprofit to be state exchange's only co-op insurer

The new nonprofit health insurance company sponsored by state physicians' groups and intended mainly to provide coverage for individuals and small businesses received a license from the state Insurance Department on Monday.

"We're so thrilled," Ken Lalime, chief executive officer of the new co-op insurance company HealthyCT, said Tuesday. "This is a big milestone. We have said all along that we wanted to offer an alternative to for-profit health insurance plans, but to do that, we had to satisfy regulatory standards and provide evidence that our business plan is sound and that we can deliver. We did, and we will."

HealthyCT, sponsored by the Connecticut State Medical Society and the Connecticut State Medical Society Independent Practice Association, in June received a $76 million federal loan to provide the capital and start-up funding for the new venture, which is based in Wallingford. It also obtained a federal license to operate as a co-op insurance company.

HealthyCT insurance will be offered beginning this fall through Access Health CT, the health insurance exchange being set up by the state in response to the Affordable Care Act. HealthyCT insurance also will be available through private insurance brokers. HealthyCT coverage would begin in January. It would be the only co-op insurance available on the exchange, Lalime said.

While HealthyCT will design plans mainly for the individual and small- and mid-sized group markets, it also will have plans for large employers. Lalime said its plans would be "very competitive" with private insurance rates, both standard plans with co-pays and deductibles as well as high-deductible plans. It hopes to insure 25,000 to 40,000 individuals.

Lalime said the majority of the 7,000 doctors who are members of the state medical society and the IPA have signed up to be part of the physician network for HealthyCT. As a nonprofit, he said, any surpluses would be directed into premium reductions or enhanced plan benefits. The company also will be "consumer directed," with plan members comprising its board of directors. It also will focus on programs to foster patients and physicians working together to improve health outcomes, Lalime said.

For information, visit HealthyCT.org or follow @HealthyCTPlan on Twitter.